Is modified retroperitoneal lymph node dissection (MRLND) still feasible in the treatment of patients with clinical stage I non-seminomatous testicular cancer?

The results of treatment by means of modified RLND in 52 patients with clinical stage I non-seminomatous testicular cancer are presented. Retroperitoneal lymph node metastases were found in 15 patients (28.8%) with clinical stage I (CS-I) diagnosed prior to surgery. They received chemotherapy according to PVB schedule. Ejaculation disturbances persisted in 4 patients (7.7%). Relapses occurred in 4 patients (7.7%) from the group without lymph node metastases, and complete remission occurred after adjuvant PVB chemotherapy. All patients are still alive. Among the analysed factors which might favour development of metastases, only neoplastic invasion of the blood vessels of the primary tumour was statistically significant. In the authors' opinion MRLND may still be used as a diagnostic and therapeutic method in clinical stage I non-seminomatous testicular cancer besides "watch policy" or primary chemotherapy.